title: The influence of medical testing on patients' health: an overview from the gynecologists' perspective.
abstract: BACKGROUND
  A medical tests may influence the health of patients by guiding clinical decisions, such as treatment in case of a positive test result. However, a medical test can influence the health of patients through other mechanisms as well, like giving reassurance. To make a clinical recommendation about a medical test, we should be aware of the full range of effects of that test on patients. This requires an understanding of the range of effects that medical testing can have on patients. This study evaluates the mechanisms through which medical testing can influence patients' health, other than the effect on clinical management, from a gynecologist's perspective.
  
  
  METHODS
  A qualitative study in which explorative focus groups were conducted with gynecologists, gynecological residents and gynecological M.D. researchers (n = 43). Discussions were transcribed verbatim. Transcriptions were coded inductively and analyzed by three researchers.
  
  
  RESULTS
  All participants contributed various clinical examples in which medical testing had influenced patients' health. Clinical examples illustrated that testing, in itself or in interaction with contextual factors, may provoke a wide range of effects on patients. Our data showed that testing can influence the doctor's perceptions of the patients' appraisal of their illness, their perceived control, or the doctor-patient relationship. This may lead to changes in psychological, behavioral, and/or medical outcomes, both favorably or unfavorably. The data were used to construct a conceptual framework of effects of medical testing on patients.
  
  
  CONCLUSIONS
  Besides supporting clinical decision making, medical testing may have favorable or unfavorable effects on patients' health though several mechanisms.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. jolandevis@gmail.com.
authors.forename: Jolande Y
authors.initials: JY
authors.lastname: Vis
authors.forename: Myra C B
authors.initials: MC
authors.lastname: van Zwieten
authors.forename: Patrick M M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Karel G M
authors.initials: KG
authors.lastname: Moons
authors.forename: Marcel G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: McCaffery
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
mesh_terms: D000328:Adult; D003955:Diagnostic Tests, Routine / Q000592:standards*; D017144:Focus Groups; D006176:Gynecology / Q000379:methods / Q000592:standards*; D006801:Humans; D063868:Patient Outcome Assessment; D010817:Physician-Patient Relations; D036301:Qualitative Research